What happened
Narrowly passing in a 4-3 vote, Allegiance won the $1.3 million annual contract for the next four years with potential for an additional two years. The contract’s terms provide both emergency and nonemergency medical services, including ground ambulance transportation.
The annual bill footed by taxpayers will provide four mobile intensive care unit ambulances and their medical crews. Each MICU, as defined by state regulation, will be equipped with critical care equipment and staffed by a minimum of one EMT and one paramedic.
Allegiance has previously been contracted by the city since 2022; however, after the death of a man in the care of an Allegiance crew member in 2023—ruled medical negligence by the Texas Department of Health Services—council members also evaluated Travis County Emergency Services District No. 2 for services.
Travis County ESD 2 serves the city’s extraterritorial jurisdiction and previously served within the city’s limits before Allegiance.
A closer look
Council members voiced concerns around both providers.
Place 5 council member Jim McDonald pointed to changes in the terms of the contract presented by Travis County ESD 2. He cited a last-minute addition of escalating costs as well as an offer to refund back to the city part of the money collected by the district from hospitals for transferring a patient.
This refund falls under a federal anti-kickback statute for medicare collections, McDonald said, adding that this would be illegal.
“So, here they were offering something that, given their years of quality experience, they should have known was illegal. ... My issue here is that I don't know that I would go into an agreement with an organization that has demonstrably proved itself untrustworthy,” McDonald said.
On the other side, Mayor Victor Gonzalez stated he would not support a contract with Allegiance because of poor-quality care and last year’s death.
“I don’t think we can put a value on somebody’s life. ... We’re putting our citizens at risk with Allegiance. They had a death on their watch, and it was negligence,” Gonzalez said. “I am overly concerned that the services provided by Allegiance are subpar.”
Items worth mentioning
The city does provide oversight of EMS, which is now under the supervision of the Emergency Services Director Joseph Chacon.
The oversight includes monthly reporting on a number of National EMS Quality Alliance measures as well as response times and patient demographics, according to city staff.
Daniel Gillespie, a representative for Allegiance, informed council members during the company’s presentation May 14 that most of the company's staff have an average of four years of prior experience before being hired.
Within the past two years under contract, Allegiance has responded to 10,170 calls and transported nearly 7,000 patients to future care, according to the presentation.
The average response time by Allegiance for all calls was 6 minutes and 27 seconds, with a response time of 6 minutes and 2 seconds for high-priority calls.
For reference, the most recent state data indicates 57% of EMS runs throughout Travis County arrived in under 8 minutes.
Find more information on Allegiance Mobile Health services and training here.
